Phlebosclerotic Colitis: an Unusual Cause of Ischaemic Colitis in a 65-year-old Man

TJ Ho, CW Cheung, WM Wong, FL Chan

Hong Kong J Radiol 2005;8:53-8

Ischaemic colitis is a well-known entity that yields a wide spectrum of pathological and clinical findings. Different precipitating factors have been incriminated. Phlebosclerosis involving venous drainage into the colon has been previously described in Japanese patients as a unique form of ischaemic colitis. This report presents the first known Chinese patient with a histologically proven case of phlebosclerotic colitis. Abdominal radiography showed threadlike branching calcification over the ascending colon along and perpendicular to the bowel wall. Computed tomography of the abdomen and pelvis demonstrated colonic distension and marked symmetrical colonic mural thickening with a target appearance predominantly in the ascending colon and caecum. Extensive calcification was noted in the entire wall (on both mesenteric and antimesenteric sides) of the affected colon, along its adjacent mesenteric vascular arcade, and in the wall of branches of superior mesenteric vein. Computed tomography angiography showed that the major branches of the superior mesenteric artery and vein were opacified. Volume-rendered images and maximal intensity projections showed that the calcifications were associated with veins and not with the arteries. The use of multidetector computed tomography is thus stressed as the imaging modality of choice.